Aging, Health Literacy, Health Status Disparities, Self Care, Social Capital, Subjective Health
Conditions
Brief summary
Motivations: Socio-economic and education determinants have a big impact on health outcomes, in terms of worse health status in populations living in more disadvantaged conditions. Social capital, self-management and health literacy are some of the intermediate determinants, with the potential to mitigate health inequalities through interventions driven by local health agents. These three determinants are intensely interlinked and have, separately, impacts on self-perceived health. Social capital is defined in this project as an umbrella concept, which includes quantitative aspects of social resources (structural social capital: social networks and contacts, social and civic participation) as well as qualitative or subjective aspects (cognitive social capital: perceived social support, feeling of belonging and trust) and covers relations between subjects at a micro or individual level (family and friends) as well as at a macro or community level. Health literacy is understood as cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Both are key aspects for self-management behaviours. The target of our research project are older people living in urban socioeconomically disadvantaged areas, since ageing is in itself an inequality axis and urban environments concentrate the highest health disparities. Objectives: With the aim to reduce health inequality, an intervention has been designed to promote self-management, health literacy and social capital among older people who perceived their health as fair or poor and are living in urban socioeconomically disadvantaged areas with the aim of improving their self-perceived health. Secondarily, the efficacy of the intervention will be analysed in terms of increasing self-management, health literacy and social capital (social support and social participation), quality of life, mental health and healthy lifestyles. In third place, behavioural health patterns will be identified in relation to health literacy, social capital, gender, socioeconomic and educational level, and they will be linked to the intervention efficacy levels.
Interventions
BEHAVIORALProgram Sentirnos bien (Feeling well)
Group-based intervention delivered face-to face and held once a week during 3 months. It comprises: 1. Promoting the uptake of self-care healthy habits: providing information, setting personal goals and sharing experiences to facilitate behavioural change, specially on physical activity and healthy dietary habits. 2. Promoting social capital at individual level: facilitating mutual knowledge and mutual support among participants and fostering participation in sociocultural and community activities in the neighbourhood through visits to the community assets accompanied by volunteers. 3. Promoting health literacy: improving navigation through the health care system, communication with health professionals, as well as the understanding and decision making when buying food.
Sponsors
Recercaixa
Equip Atencio Primaria Sardenya
Fundacio Salut i Envelliment UAB
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Investigator)
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* community-dwelling older adults living in the urban areas of Barcelona, Blanes or Reus in socio-economically disadvantaged neighbourhoods. * perception of their health as regular or bad according to the first question of the 12 items Short Form Survey from the RAND Medical Outcomes Study.
Exclusion criteria
* dependency to go to the local primary care center * cognitive decline or dementia as diagnose * any health condition that contraindicates physical activity * terminal illness * severe mental health disorders that difficult participating in a group dynamic
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Self-perceived health | at 3 months (just after the intervention) | Same question than the 12 items Short Form Survey from the RAND Medical Outcomes Study. Answers will be recategorized as positive perception (excellent, very good or good) vs negative (regular or bad) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Health related quality of life | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) | 12 items Short Form Survey from the RAND Medical Outcomes Study. |
| Self-rated quality of life | t month 3 (just after the intervention) and at month 12 (9 months after the intervention) | Thermometer from 0-100 |
| Loneliness | t month 3 (just after the intervention) and at month 12 (9 months after the intervention) | Scale Gierveld and De Jong |
| Depressive symptoms | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) | Geriatric Depression Scale |
| Physical activity | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) | International Physical Activity Questionnaire (IPAQ) |
| Short Physical Performance Battery | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) | Functional test that scores performance in three physical aspects: balance, strength and gait speed. |
| Self-perceived health | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) | Thermometer from 0-100 |
| Unintended effects | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) | Questions ad hoc to assess effects not intended by the intervention perceived negatively by the participant. |
| Self-care / healthy habits | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) | Scale ASA (Appraisal of Self-Care Agency Scale) |
| Health literacy | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) | questions from the European Health Literacy Scale (HLS EU-16) |
| Social capital | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) | 2 questions from the European Values Survey |
| Social support | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) | Questionnaire Inventario de recursos sociales en ancianos from Díaz Veiga |
| Social participation | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) | Questionnaire Escala Este II de Soledad - Índice de participación social subjetiva |
| Health service use | at month 3 (just after the intervention) and at month 12 (9 months after the intervention) | Times attending primary and hospital health care |
Outcome results
None listed